CLAIMS RECORD 2014 7/10 Our claim experience shows us that seven out of ten individuals will experience at least one illness or injury that will stop them from earning an income during their working lives. And yet, we know that South Africans are still dangerously under-insured for disability risk. COULD YOU SURVIVE 90 DAYS WITHOUT AN INCOME? 76 PERCENT of our claims last less than 90 days. We know that 76% of our claims in 2014 lasted less than 90 days, and the average claim length in 2014 was 82 days. While this might seem like a small amount of time, imagine no income for almost three months. And worse still, if you're self-employed it s unlikely that you'll have a sick leave benefi t so every day off work is a day you're not earning an income. Would you survive? What would happen to you or your family without an income, even for a short while? Your insurance policies, medical aid, house and car re-payments all depend on monthly premiums being paid! 62% of South Africans are behind in their debt payments, and they don't have adequate savings, so even a temporary break in income could have devastating long-term consequences. Despite this clear need most South Africans are not properly covered for temporary disability, if they have cover at all. Average claim duration At FMI our philosophy is simple. We pay claims. For more information please contact our FMI Financial Advisers Distribution Team on 0860 10 52 08, sales@fmi.co.za or www.fmi.co.za Insured by Guardrisk Life Ltd FSP 76. FMI is an authorised Financial Services Provider. FSP 2717. *stats based on FMI policyholders
Choosing the right waiting period is key! When choosing cover, an important consideration is the waiting period the time from the fi rst day of disability till your benefi t begins to pay. We offer a range of waiting periods 7, 14, 30 or 90 days and we allow you to place your cover across several waiting periods. This means you can tailor cover to suit your needs matching the different income sources you may have commission, salary, bonus payments etc. You are 4 times more likely to have a claim on a than on a 90 day waiting period. Waiting Periods COVER ON 7 DAY WAITING PERIOD: Cover: R30,000 per month Premium: R304.81 OR SPLIT COVER OVER DIFFERENT WAITING PERIODS: Cheaper premium, with cover from day 1 Cover: R10,000 () Cover: R10,000 (14 day waiting period) Cover: R10,000 (30 day waiting period) Premium: R227.54 AND IT CAN HAPPEN MORE THAN ONCE SELF-INSURANCE IS SIMPLY NOT AN OPTION! Multiple claims 46% 46% of claims in 2014 were for policyholders who had claimed before. While FMI has benefi t terms to cap the maximum period that is paid for any single claim, there is no cap on the number of TIP claims that can be made. This means our TIP cover is a benefi t you can use throughout your working life. And for related claims, within 24 months, we waive the waiting periods to ensure complete cover and a speedy pay-out when its needed most. 8% 9% 19% Wally, Multiple Claims 4% 6% 2014 TIP Claims 54% No prior claims 1 prior claim 2 prior claims 3 prior claims 4 prior claims 5 or More A fi nancial adviser, Wally understands the importance of income protection. Being self-employed, he knows that if he cannot work, he will not be able to earn an income or support his family. The same goes for his clients. Because FMI allows for multiple claims, Wally was able to claim for two incidents in 2013, he was involved in a cycling accident, resulting in multiple injuries and three weeks off work. Wally points out that a short waiting period is a must for self-employed individuals, Because I had a 7 day waiting period, I was able to move quickly into claim stage, with the peace of mind that I was covered during my time off. Because, even with a fl ow of income, missing out on new business while unable to work can have a knockon effect. In 2014, Wally claimed for a hernia operation which kept him off work for ten days due to complications. FMI paid the claim quickly and easily speed is a part of the FMI culture. The simplicity of the product and the ease of claiming mean FMI is my product of choice for income protection.
DON T FORGET YOU DO STILL NEED LONG-TERM DISABILITY COVER Even though long-term or permanent disability is less likely to occur, it does still happen and when it does, the costs are big. With high levels of debt and lack of savings, self-insurance is not an option. Your family and employees depend on your income to maintain their quality of life, so you need to make sure you also cover long-term disability. 4% Chance of a claim lasting longer than a year. While this may seem small, the risk of what you could lose is great. John earns R40 000 per month. one year with no income R480 000 income lost disabled at 40 and couldn't work again R40 million income lost EVERYDAY EVENTS COULD STOP YOU EARNING AN INCOME Everyday illness and accidents can prevent you from being able to earn an income. And illnesses represent a much bigger risk with the majority of our claims being due to illness not injury. 80% to claims due illness Elmarie, Illness Claim A sales commission earner and the sole provider for her two young children, Elmarie understands the importance of protecting her income, After my fi rst claim, I realised how devastating it would have been if I didn t have the certainty of a product like FMI s income protection. Despite being ill for a while, Elmarie believed she couldn t afford to take time off work. However, her illness caught up with her and she was fi nally hospitalised for a minor procedure. This meant she was unable to work for two weeks. Elmarie warns that this is worse than one might think, When you work on commission, it s not just your income that s affected, it s your relationships with your clients as well. I was really concerned about how I would pay daily bills and provide for my children without my regular income. But FMI was fantastic I contacted them as soon as I was hospitalised, submitted my claim online, and received feedback at every stage of the process. When you deal with FMI, you can feel they have your best interests at heart. Because Elmarie has an FMI policy, she was able to focus on getting better, secure in the knowledge that she was not in a worse fi nancial position because she was not able to work for a certain amount of time. Her advice? Income protection is a safety net. Anyone who works should consider having an income protection policy. It is one of the most important insurances you can have.
Causes of Illness Claims Musculo-skeletal 24% 14% Kidney or Internal Organs 14% Urogenital 11% Spinal Cardiac 8% 6% Respiratory Other 23% Alan, Accident Claim Business owner Alan has been in the fl ooring business for over 30 years. When a 400kg roll of carpet fell off a vehicle roof onto his shoulder, he sustained serious back injuries and had to be booked off work for three months. Fortunately for Alan and his family, he has income protection with FMI. He explains, While I was seriously stressed about being confi ned to my bed for three months, especially as I am a one man business, I had the peace of mind that comes with having income protection. Without income protection, it would have been incredibly diffi cult for Alan to sustain his business and support his family, I managed to maintain sales, using the pay-outs from my FMI policy to employ a friend I trusted who needed work. In this way, FMI helped us both through very diffi cult times. You might think you can t afford cover like this, especially when times are tough, but you have to make a choice about what s important in your business, what will help you survive to fi ght another day. Income protection is one of those key choices. PAY-OUT RATIO FOR SUBMITTED CLAIMS IN 2014 95% Our philosophy is simple. We pay claims. With our expert underwriting and assessment, comprehensive claims criteria, and minimal claim requirements, we believe a claim with FMI has more chance of being paid than with anyone else. It s important for clients to fully understand the terms of their cover so when they claim for a valid reason, they can rest assured of being paid. And if all your paperwork is in order we could pay within 24 hours! Magda Briers, Head of Claims
Claim Certainty with FMI Fast Track Guaranteed sickness Guaranteed minimum period Childbirth Most generous terms in the market for minor infections. Quick payment for a guaranteed period! 12 x total monthly premium unmatched in the market! No standard restrictions on back claims! Claim If you still cannot work, then claim will be assessed on occupational disability. No restrictions on claims related to female reproductive system. Occupational disability Note: Driver s extension applies on occupational disability claims. Partial disability Loss of Income You choose highest pay-out. Functional impairment % Disabled But, non-disclosure is still our biggest concern The most important thing is to be truthful at underwriting stage this makes claiming so much easier. Magda Briers, Head of Claims To avoid non-disclosure problems at claim stage, you need to reveal all historical and current medical conditions up front at underwriting stage. But even when an applicant is trying to be completely honest, non-disclosure can still occur. Tele-underwriting reduces the risk of non-disclosure Talking directly to an underwriter can greatly reduce the risk of non-disclosure. Only 4.46% of claims submitted in 2014 were not paid. 92% of these were as a result of non-disclosure. Alison, Claim declined due to non-disclosure A self-employed medical practitioner, Alison recently claimed for a major depressive period, with a recovery period of one month. When applying for her income protection policy, she declared a brief period of depression 10 years ago but stated that, after a short course of treatment, there had been no recurrence, symptoms, or treatment. However, at claim stage, her medical history revealed that she had received treatment for depression and anxiety 6 months before applying for the policy. The claim was declined based on the fact that, had FMI known about this treatment, an exclusion for psychological conditions would have been applicable to her policy. Therefore the claim would not be valid.
CLAIMS WE'VE PAID IN 2014 We cover a wide range of occupations and claim scenarios that prevent a person from earning an income. CLAIM STORY COVER PAY-OUT 48 year old female business owner in the Health and Wellness industry claiming for internal acoustic neuroma. Claim duration: 150 days 39 year old female business owner claiming for hysterectomy. Claim duration: 43 days 31 year old male mechanic fell off a harvester and injured his right knee, resulting in ACL reconstruction. Claim duration: 101 days 40 year old female dentist claiming for a laparoscopic procedure for extensive endometriosis. Claim duration: 43 days R28 890.63 30 day waiting period R 71,471.77 R 18,375.00 24 months benefi t term R 50,000.00 12 month benefi t term R 21,000.00 R 113,979.60 R 101,039.68 R 51,651.25 R 70,685.12 41 year old female hotel owner diagnosed with metastatic cervix cancer and secondary kidney failure. Hospitalised for treatment. Claim duration 93 days. 58 year old male fi nancial adviser initially claiming under Guaranteed Sickness Benefi t for acute gastritis but failed to respond to treatment. Subsequently diagnosed with metastatic cancer of pancreas. Chemotherapy and on chronic pain meds. Claim duration: Initial claim of 10 days extended by 122 days, and then to 253 days. 43 year old female managing director claiming for depression. Claim duration: 540 days (18 months) and still in payment 62 year old female lawyer claiming for cancer. Claim duration: 6 years 3 months and still in payment With FMI, you re covered by experts Hospitalisation Enhancer R 4,200.00 6 month benefi t term Dread Disease Enhancer R 4,200.00 6 month benefi t term R 42,000.00 R 21 500 R 43 000 30 day waiting period R 150 000 Business Overhead Protector 30 day waiting period 6 month benefi t term R42 000 R48 620 EIP R 64,208.13 R 349,347.46 R 1 881 794.34 (paid to date, and still in payment) R 2 260 269.17 (paid to date, and still in payment) Whether you consider us niche, extremely focused or obsessively passionate, one thing you can be sure of is that we are experts when it comes to income protection.